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APPLICATII .i FOR CONSTRUCI aN PERMIT <br /> CITY OF EVERETT•BUILDING OIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> (l UEMOLITION fl COMBINATION fl BUILDING f7 MECHANICAL �� PLUMBING fl SIGN <br /> PROJECTADORESS v �U— • <br /> /GZO (G'L�, � <br /> OWNER MAILAppRE55 CITY 21P PNONE <br /> �rrr� /N�.�v�i�1 /�ZG CaL�f�A�/E �riac'�i'r �o/ �g- �gZz <br /> TENANT MML�DORE55 CITY IIP PNONE < <br /> ARCNITCCT OR OESIGNER M�IL AD�RESS CITY IIP PHONE <br /> OENEP0.CCYiMLTOR MAILADDRESS piY plP P110NF ST�TE LICENSE� <br /> MECH/ANI�A�CONTRACTOR MAILADUPE55 CITV 21P PIIONE STATELI�ENSE• <br /> �J� <br /> PLUMBINGCONTFICTOP MAILAUDRESS GiV 21P PNONE STAiEUCENSE� � <br /> C TRICTPRICEOFYNpK � <br /> �Qp(�'�-� HEATING SYSTEM: �GAS rl ELECTRIC fl <br /> DESC IBEWOPK�NUSOUAREFOOTAGEINVq.VED LONT�CTPERSONANOPHONENO. ��N �G �JI/� <br /> % C /2� ChD c�'TG/ /l//�TGi��L <br /> E�i� �!//P,�URCF /�"N.17 SO C L. NGT <br /> ��� .�Nh. � I HEREBY CERTIfY THAT I HAVE READ AND EXAMINED THIS <br /> PaOaO��pf BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> K PROVIS�ONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCRIPTIONOFPPOPERTV�SHOWNBELOWORATTACHTWOLOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior etocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFOHM TNE WORK FOR WH�CH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PARCEL LUf L0.NUMBER CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSiRVC�10N LOAN LENDER.�DORE55,TELEPMONE NUMBEH �/"7 •��_. Z J�/� <br /> SICa UR D�TE <br /> LITV BUSINE55 LICENSE N0. <br /> PLUMBINO MECHANICAL <br /> NO. TVPE OF FlXTURE OR IiEM FEE NO. T'PE OF EGUIPMENT FEE <br /> WATER CLOSET(TOIIET) � q/C—A/HNDLQ UNITS—H.P. � <br /> BATHTUB _ � FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP i <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 D�SP ; CLOTHES DRVERS ; <br /> DISHWASHER � VENTILATION FAN � <br /> �__ <br /> LAUNDRY TRAY � RAIJGE HOOD � <br /> CLOTHES WASHER � WATEq HEATER —�— <br /> URINAL � WOOD STOVE ' <br /> DRINKING FOUN7AIN � ; METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR ORAIN FIREPLACE INSERT(WOOD BURN�NG) � <br /> BACKFIOW PREVENTERS ; GAS FIREPLACE ; <br /> SIMK(SERVICE—BAR, ETC.) GAS RANGE � <br /> ' 'z GAS PIPING <br /> � EXHAUSTFAN � <br /> i � <br /> � � <br /> � <br /> SUB TOTAL E ; SUB TOTAL $ � <br /> PERMIT $ i PERMIT $ � <br /> TOTAL FEE S � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSF.TBACK REARSETBA�N S�DESET9�CN PLANCIIE NUIPBER FEE PECEIPTNO. <br /> �f�� 3? <br /> use zoNe i.ot nnen VACANi SITE FEES VALUATION FEE <br /> f1YE5 I7 NO BIIIIIIMG i <br /> IIEIG��TLIMITATION NOOFDW6WN0 SIZEOFBLOGRJ � <br /> 11N115 PIUMpINO i <br /> OCCUP�NCY NO O�SIORIES OLCUP�NTIOAD B�SEMENT �± <br /> f.AOUP MECNnNICRI <br /> / � <br /> f1Yf5 I1 NO — � <br /> FIRE�LARM qE0I1 REASON ADDILIONAL PLAN CMCGK � <br /> 1 <br /> 0141ER � <br /> i <br /> FIRESPRINKIERRE00 REnSON � <br /> STNE OUq01NG SIInL11MCL <br /> i <br /> --�-- <br /> TYPEOPf,ON$T PI�NSRPPROVE�OY CITYOFEVERETT �UPIIf.WOf1K5 <br /> i <br /> LQCAL SALES '— <br /> nnre TAX CODE IS 3105 TOTAL I <br /> ..��r <br />